The Kellgren and Lawrence Score as a helpful tool for the indication for total disc replacement at the cervical spine

Article type: Research Article

Authors: Struwe, Charlotte^* | Bornemann, Rahel | Schildberg, Frank Alexander | Wirtz, Dieter Christian | Pflugmacher, Robert | Rommelspacher, Yorck

Affiliations: Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn, Bonn, Germany

Correspondence: [*] Corresponding author: Charlotte Struwe, Clinic for Orthopedics and Trauma Surgery, University Hospital Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany. Tel.: +49 151 58 23 29 83; Fax: +49 228 287 14175; E-mail: [email protected].

Abstract: BACKGROUND: Several studies showed encouraging results after total disc replacement (TDR) in patients with cervical-brachial syndrome (CBS). OBJECTIVE: The aim of this study was to supplement the existing documentation of results after total disc replacement and to underline the importance of the correct indication. METHODS: The clinical and radiological outcome of 34 patients was evaluated in a 2-year follow-up by several parameters as the Visual Analogue Scale (VAS) for pain, the Neck Disability Index (NDI) and the Kellgren and Lawrence Score. RESULTS: The median values for NDI changed from 65% (20–90) before surgery to 20% (0–86) 2 years after surgery (p< 0.0001). Pain intensity had an average rate of reduction from 8.4 ± 2 cm (VAS scale 0–10 cm) to 2.9 ± 2 cm (p< 0.0001). A median of 1 (0–3) was calculated for the Kellgren and Lawrence Score in the affected segment preoperatively. Due to loosening in five cases the TDR was removed and changed into anterior cervical decompression and fusion (ACDF). In all of these five cases a preoperative Kellgren and Lawrence Score of 2 or 3 was calculated and five of five patients (100%) were smokers. CONCLUSION: The use of TDR in nonsmoking patients with a low preoperative Kellgren and Lawrence Score of 0–1 lead to a clinically and radiologically successful outcome.

Keywords: Cervical brachial syndrome, total disc replacement, cervical spine

DOI: 10.3233/THC-191614

Journal: Technology and Health Care, vol. 27, no. 3, pp. 317-326, 2019